Mortality rates in diarrheal diseases attributable to unsafe water sources among children aged under 5 years in Türkiye and by income groups, 1990–2023: a longitudinal analysis

4th International Conference on Recent and Innovative Results in Engineering and Technology, Konya, Turkey, 27 - 28 April 2026, pp.74-81, (Full Text)

Diarrheal diseases remain a major contributor to global mortality and morbidity among children. This

study aims to assess mortality rates and disability-adjusted life years (DALYs) attributable to unsafe water sources

among children under 5 years of age from 1990 to 2021. The analysis is stratified by income group at global, regional,

and national levels. Data were obtained from the 2023 Global Burden of Diseases, Injuries, and Risk Factors Study

(GBD). Children under 5 years with diarrheal diseases were included in the analysis. Results are presented with 95%

uncertainty intervals (UIs), and fold changes were calculated. Joinpoint regression was used to identify statistically

significant changes in trend over time. Between 1990 and 2023, mortality and DALY rates from diarrheal diseases

attributable to unsafe water sources declined markedly across all regions. Globally, deaths decreased from 216.55

(112.57–311.64) to 36.37 (17.39–56.81), an 83% reduction, with DALYs falling from 19,535.67 (10,141.56–

28,042.82) to 3,311.60 (1,594.51–5,152.90). Türkiye showed sharper declines, with deaths dropping from 50.15

(16.21–97.05) to 1.46 (0.54–2.64) and DALYs from 4,777.24 (1,606.76–9,083.71) to 182.43 (64.54–317.74).

Reductions exceeded 90% in high- and upper-middle-income countries, while low-income countries had smaller

declines and the highest remaining burden. The global burden of childhood diarrheal diseases has declined but

remains a substantial contributor to DALYs. These findings underscore the need for region-specific water safety

interventions in high-burden settings and provide important evidence to inform public health strategies and policy

decisions for prevention.